B超定位下精准化肠道清洁管理对ICU危重症患者肠屏障功能的影响  

Effect of b-scan ultrasongraghy-guided intestinal cleansing on intestinal barrier function of ICU patients

作　　者：沈燕[1] 费凯红[1] 黄春梅 俞佳琦 姚叶英 杜江[1] Shen Yan;Fei Kaihong;Huang Chunmei;Yu Jiaqi;Yao Yeying;Du Jiang(Department of Intensive Care Unit,Shanghai First People's Hospital,Shanghai,201620,China)

机构地区：[1]上海市第一人民医院重症监护室,上海201620

出　　处：《现代临床护理》2020年第6期46-50,共5页Modern Clinical Nursing

基　　金：上海交通大学医学院科技基金项目,项目编号为JyhZ1810。

摘　　要：目的探讨B超定位下精准化肠道清洁管理对ICU危重症患者肠屏障功能的影响,以便为改善危重症患者肠屏障功能损伤提供一种有效的方法。方法采用随机对照试验方法,采用简单随机数表法将191例患者随机分为对照组85例和试验组106例。对照组采用常规方法触诊、叩诊、听诊评估患者排便情况,依据其是否发生便秘给予通便或小量不保留灌肠;试验组在B超定位下评估肠管扩张情况,扩张评分≥5分给予通便或小量不保留灌肠。比较两组患者入院第1天、第4天、第7天后肠屏障功能检测指标,比较两组患者住院期间MODS发生率及ICU住院时间。结果入院第4天,第7天试验组患者二胺氧化酶、D-乳酸指标均低于对照组,两组比较,差异具有统计学意义(均P<0.05);试验组患者ICU住院时间短于对照组,两组比较,差异具有统计学意义(均P<0.01);两组患者MODS发生率比较,差异无统计学意义(P>0.05)。结论在ICU重症患者中采用B超定位下精准化肠管扩张评分,指导护士及时做好重症患者肠道清理工作,可有效改善患者肠屏障功能,缩短患者住院天数,值得临床推广应用。Objective To analyze the effect of b-scan ultrasongraghy-guided intestinal cleansing on the improvement of intestinal barrier function so as to provide an effective method for improving the intestinal barrier function of critically ill patients.Methods A prospective randomized controlled trial was conducted.The simple random digit number table was used to randomize 191 patients in the ICU into control group(n=85)and trial group(n=106).In the control group,defecation was evaluated by palpation,percussion and auscultation,and in case of constipation,defecation was conducted or small amount of enema was performed.In the trial group,defecation was evaluated by b-scan ultrasongraghy to identify the degree of intestinal distention,and in case of the distention≥5,defecation was conducted or small amount of enema was performed.The two groups were compared in terms of indicators of intestinal barrier function on day 1,4 and 7,incidence of MODS and ICU stay.Results The diaminoxidase and D-lactic acid were lower in the trial group on day 4 and 7 after treatment(P<0.05).The ICU stay in the trial group was significantly shorter than that in the control group(P<0.05).There was no significant difference in the incidence of MODS between the two groups(P>0.05).Conclusions The b-scan ultrasongraghy-guided evaluation of intestinal distention effectively directs nurses into proper intestinal cleansing of ICU patients.It is also effective in promoting their intestinal barrier function and shortening the hospital stay,worth clinically spreading.

关 键 词：B超定位 肠道清洁 危重患者 肠屏障功能 随机对照试验 

分 类 号：R47[医药卫生—护理学]